Jumping Through Hoops Part II

What Does “Qualified” Mean Anyway?: Yesterday’s post brings us to another gripe with insurance companies and their in-network lists. When therapists decide to join a company’s in-network list, they fill out a stack of papers, listing their background, specialties, qualifications, etc. There is usually a list of languages that you can check off, to indicate your “fluency” in any number of languages, including ASL, or sometimes just “sign language”. All anyone has to do to indicate that they are “qualified” to work with Deaf clients, is make a little notation in the ASL box. That’s it. No need to provide certification or any evidence attesting to your signing ability or knowledge and familiarity with Deaf culture. See here for the actual provider application (scroll down to the top of page 6).

We have had clients tell us horror stories about how their insurance companies referred them to therapists who had noted their ASL fluency on their in-network provider application, only to find out that the therapists knew four signs or had taken one course in ASL or had a hard-of-hearing great-uncle and “knew how to communicate with Deaf people”. See this story for a tragic and totally unnecessary ordeal one Deaf man and his family experienced while seeking a qualified therapist.

Even if an insurance company does have in-network therapists who can sign, the Deaf client may not always want to see one of these therapists. It could be that the client already knows the therapists on a social basis – maybe they went to Gallaudet together or maybe the therapist is the Deaf person’s mother’s best friend or something like that. In this type of situation, it only seems fair that the insurance companies recognize the limited choices of therapists they are offering the Deaf person (compared to the hundreds of choices they offer their hearing members) and allow sessions with an out-of-network therapist at no additional charge.

Yes it is definitely something to scream about. I think this may be need to corrected by legislation. I wonder how the medical insurance companies would respond to a bill in Congress to make all out-of-network minority language providers equivalent to in-network providers for reimbursement or else face lawsuits for discrimination and ignoring the ADA.

It’s all about money and health care costs are spiraling and my company gets routine information from our healthcare company saying that costs are going up for them and how can we keep healthy etc.

The population is aging right now, and that means medical needs per individual is going to steadily increase. But it’s not right for them to try and cut corners by stubbornly sticking to company policy when the end result could be far more expensive, not just in lawsuits but actual emergency medical care for untreated conditions thanks to lack of communication.

Let’s go to the heart of the problem: each insurance company needs individual “counseling” (a.k.a. educating) by a qualified advocate who will gently, with humor steeled with a no-nonsense approach, educate insurance company representatives as to the errors of their “ways.” Sure this seems a herculean task. Yet, I’d count even ONE enlightened insurance company as a success to flaunt.

It’s not just insurance companies where advocates can do their greatest work. The entire medical field could do with some “counseling”. Especially, I want to see medical schools include mandatory courses for future doctors and nurses. I mean “courses”…not a one-time lecture or presentation. That never works for the majority.

As a relucant Deaf consumer of the medical establishment I have done my share and more of “counseling” seemingly to no avail. Have I given up? Naw! I keep hoping I’ll meet that one “enlightened” doc/nurse/orderly/administrator/SOMEBODY who’ll take their colleagues to task for their insensitive (and nonsensical) behavior. Y’know? Hope springs eternal!